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Health Care Reform for Beginners: The Senate Finance Committee

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My colleague Ceci Connelly had a nice profile of Sen. Max Baucus (D-Mont.) over the weekend. Read it. It also happens to be a nice segue into the second entry of "Health Reform for Beginners."

You hear a lot about the "how" of health care reform. You hear a fair amount about the "who" of it. You even get some "when." But you don't hear that much about the "where." But the "where" matters. And the where, somewhat confusingly, is primarily the Senate Finance Committee -- the same committee chaired by Baucus.

There are two reasons for this. The first is that pushing health care reform through the United States Senate is harder than pushing it through the House of Representatives. The reason is simple enough: The filibuster. If House Speaker Nancy Pelosi could handle health reform on her own, the bill would be signed by lunchtime Wednesday.

The second has to do with the confusing composition of the Senate's committee. There is, after all, a more obvious committee where health reform could dock: The Health, Education, Labor, and Pensions Committee. "Health," after all, isn't even that committee's middle name. It's its first name.

The catch, however, comes in rule XXV of the Senate, which contains the Senate Finance Committee's charter. Among its areas of jurisdiction: "Health programs under the Social Security Act and health programs financed by a specific tax or trust fund." Health programs, in other words, that will cost money. And health reform will cost money. If this were just a matter of insurance market reform -- or simple regulations, in other words -- the HELP committee could bear the burden on its own. But since reform requires money, they're the junior partner to the Finance Committee.

This has certain implications. The HELP Committee is traditionally quite liberal. It's led by Sen. Ted Kennedy (D-Mass.) It's dominated by old-line liberals like Sens. Chris Dodd (D-Conn.) and Tom Harkin (D-Iowa). The Finance Committee isn't. It's led by Baucus, who has traditionally been understood as a conservative Democrat. The most influential members are centrists like Sens. Chuck Grassley (R-Iowa) and Blanche Lincoln (D-Ark.).

Health reform legislation will need to pass through those members before it reaches the Senate floor. The HELP Committee's partisans will complain that Finance's centrality means a much more conservative bill. The Finance Committee's partisan will tell you that their process means a bill much likelier to beat a filibuster. They're probably both right.

Related: My profile of Max Baucus and the Senate Finance Committee

By Ezra Klein  |  May 26, 2009; 2:04 PM ET
Categories:  Health Reform , Health Reform For Beginners  
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It will be interesting to see how "where" questions like this shift if the Democrats somehow gain a few more Senate seats in 2010 while the House stalls out or slips a bit (as FiveThirtyEight seems to be projecting). We may well end up with issues where the House is more of a bottleneck than the Senate, and it could be tough to tell in advance which issues those will be.

Posted by: tomveiltomveil | May 26, 2009 3:59 PM | Report abuse

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